PROJECT SUMMARY/ABSTRACT We propose to assemble a multi-PI/PD Linked Clinical Research Center (LCRC) at the University of Southern California (USC) and Saint Luke?s Mid America Heart Institute (MAHI) in Kansas City ? high volume centers committed to enrolling patients in clinical trials. The USC-MAHI LCRC will leverage CTSI programs at both USC and MAHI, while also bringing in implementation science experts from Washington University in St. Louis, and the University of California San Francisco (UCSF) to build an educational platform that spans our centers and trains the next generation of clinical researchers in cardiothoracic surgery. This unique LCRC will increase the capacity of the CTSN to successfully conduct trials in regions with high disease burden, low socioeconomic status, ethnic and racial diversity. The specific aims of the USC-MAHI LCRC are to (1) leverage USC?s experience within the CTSN and its synergistic relationship with MAHI to increase the CTSN?s capacity to successfully conduct clinical trials in areas of high disease burden, low socioeconomic status, and ethnic and racial diversity, (2) foster the development of the affiliate site in the performance of randomized control trials, trial mechanics, and increase the affiliate?s ability to independently participate in federally sponsored trials in areas of need and high disease burden, (3) assemble a collaborative team of expert researchers at USC, MAHI, and the NHLBI K-12 T4 Implementation Science research programs that will apply innovative implementation science research methodology designed for sustainably improving the population-level translation of future CTSN studies, and (4) establish a development platform that is inclusive with respect to gender and race for the next generation of independent cardiothoracic implementation science researchers at both the primary and affiliate sites. These specific aims will require building a large multidisciplinary team spanning multiple institutions. Aim 1 will be conducted through the robust multidisciplinary clinical networks at both the primary and affiliate site, while Aim 2 will involve an innovative and novel mentoring plan between the primary and affiliate site, which leverages multiple entities, including the Clinical and Translational Science Institutes at both sites. Aim 3 will be accomplished by bringing experts in implementation science at USC, MAHI, Washington University in St. Louis, and the University of California San Francisco into the CTSN infrastructure to assist with trial design and execution. Healthcare policy and economic experts at MAHI and the Schaeffer Center for Health Policy & Economics at USC will also engage the CTSN. Aim 4 will be addressed through the formation of a Clinical and Implementation Research Skills Program Plan which, while based at USC, will leverage resources across multiple institutions including the clinical trial, community engagement, and KL2 programs at the Southern California and Frontiers Clinical and Translational Science Institutes, the Mid America Heart Institute Cardiovascular Outcomes Research Fellowship (T32 program), and our experts in implementation science.